心脏移植术后的免疫抑制治疗与排斥反应的监测

New immunosuppressive triple therapy and monitoring following orthotopic heart transplantation

目的 探讨心脏移植术后排斥反应的监测指标及免疫抑制治疗效果。方法 对 4例原位心脏移植患者术后给予他克莫司 (FK5 0 6)、霉酚酸酯 (MMF)及泼尼松组成的新三联进行免疫抑制治疗 ,同时进行急性排斥反应的监测。结果 死亡 1例 ,存活 3例 ,该 3例未发生急性排斥反应 ,且生活质量良好 ;由FK5 0 6、MMF及泼尼松组成的新三联免疫抑制效果良好。结论 FK5 0 6、MMF及泼尼松的免疫抑制效果肯定 ,副作用少 ;排斥反应监测应把无创性检查与心内膜活检有机地结合起来。

Objectives To study the monitoring parameters of the acute rejection following orthotopic heart transplantation (OHT) and the therapeutic effects of new triple therapy. Methods Four patients undergoing OHT received triple therapy of tacrolimus+mycophenolate mofetil+prednisone and the monitoring for the acute rejection. Results Three patients survived with good quality of life and no episodes of acute rejection occurred. One case died of post operative hepatic renal failure 18 days after operation. Conclusions New immunosupprossive triple therapy is effective and safe. Combination of some clinical examinations and endocardium myocardial biopsy could monitor acute rejection.